Laboratory values in acute malignant hyperthermia

Laboratory study	Laboratory value that supports the diagnosis of MH
PaCO₂	>60 mmHg during controlled ventilation
PaCO₂	>65 mmHg during spontaneous ventilation
Serum potassium	>6 mEq/L, in patients without renal failure
Arterial pH	<7.25
Base deficit	≥8 mEq/L
Creatine kinase*	>20,000 units/L after administration of succinylcholine
Creatine kinase*	>10,000 units/L without administration of succinylcholine
Urine myoglobin*	>60 mcg/L
Serum myoglobin*	>170 mcg/L

Typical laboratory values used to confirm the diagnosis of acute malignant hyperthermia.

PaCO₂: partial pressure of arterial carbon dioxide; MH: malignant hyperthermia.
* Creatine kinase and myoglobin levels peak at approximately 14 hours after an acute MH event.

Adapted from: Larach MG, Localio AR, Allen GC, et al. A clinical grading scale to predict malignant hyperthermia susceptibility. Anesthesiology 1994; 80:771.

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Laboratory values in acute malignant hyperthermia